Individual
DR. JUAN PABLO CORDOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1159 NIKKI VIEW DR, BRANDON, FL 33511-4879
(212) 523-4000
Mailing address
1159 NIKKI VIEW DR, BRANDON, FL 33511-4879
(212) 523-4000
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
ME128325
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
ME128325
MEDICAL LICENSE
FL
Enumeration date
08/04/2010
Last updated
07/11/2016
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